Measuring Disability-Associated Appraisals for Veterans With Spinal Cord Injury

Objective: Psychological adjustment following spinal cord injury and disorders (SCI/D) is a complex process. According to the Stress Appraisal and Coping Model, appraisals may mediate the relationship between disability and psychological adjustment. The purpose of the present study was to examine the psychometric properties and clinical utility of a short form of the Appraisals of Disability: Primary and Secondary Scale (ADAPSS-sf), a 6-item measure adapted from the original 33-item ADAPSS questionnaire. Design: As part of routine clinical care at a VA Medical Center, 98 Veterans (96% male, mean age = 56) with SCI/D completed study measures as part of their annual comprehensive SCI/D evaluation. Principal-components analysis was used to examine the factor structure of the ADAPSS-sf. Multivariate linear regressions were used to examine the relationship between appraisals of disability and life satisfaction, controlling for demographics, injury characteristics and depressive symptoms. Results: Demographic and SCI characteristics of the study sample are comparable to a national Veteran sample. Factor analysis revealed a 2-factor structure within the ADAPSS-sf. One factor represented appraisals signifying fear and loss, whereas the second factor represented appraisals reflecting resilience. Linear regressions showed that Veterans' disability-associated appraisals were strongly associated with life satisfaction. Conclusions: Study findings support the internal validity and a coherent 2-factor structure of the ADAPSS-sf in an outpatient Veteran population with chronic SCI/D. Additional research is warranted to test the clinical utility of the ADAPSS-sf with Veterans with SCI/D.